Member Services Manager

Location: Louisville, KY 40223 Status: Full Time, Employee Job Category: Customer Support/Client Care Relevant Work Experience: 5+ to 7 Years send this job to a friend Job Description JOB DESCRIPTION  For HR Use Only:Job Title: Operations Manager  Job Code: Job Title this Position Reports to: Director of Operations  Exempt/Non-Exempt: Department/Business Group: Insurance Services  Other:   I. OVERVIEW/GENERAL PURPOSE OF POSITION The Operations Manager will be responsible for direction and management of the CIGNA Medicare Rx Insurance Services Call Center Operations portion of NationsHealth.  Duties include;  analysis of targets and results in order to ensure that plans meet all Service Level Agreement metric goals; maintaining appropriate staffing levels consistent with budget levels, monitoring the Quality Assurance process in order to ensure a high level of customer satisfaction; coordination of the Health Insurance Licensing process ensuring that all Licensed agents maintain valid licenses.  Responsible for the hiring, training, and professional development of a staff of 5 Supervisors with each Supervisor of the leadership team subsequently being responsible for a staff of 10 to 15 agents.  II.  ESSENTIAL DUTIES AND RESPONSIBILITIES 1. Work closely with Team of Supervisors on the day to day operation of the CIGNA Medicare Rx Call Centers.  2. Review daily, weekly, and monthly reports regarding the performance of assigned teams and their achievement of set goals.  Design and implement action plans; as necessary; to ensure all teams consistently meet goals.3. Work closely with the Compliance Team to ensure that all facets of the Valid License Action Plan submitted to CIGNA are in place in both the Sunrise & Ft. Pierce facilities, and that all Enrollments performed by a NationsHealth Health Insurance agents are performed by an agent holding a valid License in the state that the beneficiary will be utilizing their CIGNA Medicare Rx benefit.  4. Work closely with the NationsHealth Quality Assurance team to ensure that all NationsHealth agents assigned to the CIGNA Medicare Rx program adhere to all CMS and other regulatory guidelines as well as these agents meeting Quality Assurance Monitoring Guidelines goals.5. Oversee the monitoring of the CMS system in order to ensure that NationsHealth is meeting Call Center Metric goals in a Real Time manner.6. Coordination of Payroll Audit distribution on a weekly basis for the Sunrise CIGNA Medicare Rx Teams.7. Review of employee headcount rosters for CIGNA Medicare Rx Teams in both Sunrise & Ft. Pierce.8. Review and adjust agent schedules for both the Sunrise & Ft. Pierce CIGNA Medicare Rx Teams.OTHER DUTIES AND RESPONSIBILITIES 1. Responsible for compliance with all federal, state and local laws, rules and regulations affecting Company.2. Responsible for participating in quality assurance, compliance and in-service and continuing education activities as requested by Company.3. Responsible for performing other duties and responsibilities as required.    9.  REPORTING RELATIONSHIP ____  This position has no supervisory responsibilities____  Provides work direction only__X__  Provides work direction plus has responsibility for hiring, promotions, transfers, performance management, discipline and discharge, etc. Positions supervised (identify positions reporting directly to this position) Title:___Team Leader___________ Apprx. Number in Position: __5____ Title:_________________________ Apprx. Number in Position: ________Title:_________________________ Apprx. Number in Position: ________Title:_________________________ Apprx. Number in Position: ________  IV.  JOB REQUIREMENTS Education and Experience – Required education, training, licenses, accreditation or certification and number of years and type of directly related experience.  If applicable, please identify if an alternate “equivalencyâ€� of a combination of education and experience is sufficient. Degree _________________________ Preferred major/area of study ______________________ Number of years of supervisory/management experience (if any) __________3__________ Number of years of experience ___3_____  Type of experience – 2 years in a supervisory position in the Health Insurance industry or other related experience.         Knowledge, Skills, and Abilities: 1. Intermediate skill level in Microsoft Excel, Outlook, & Word along with documented practical experience in the use of these applications.  2. Ability to be flexible in job tasks & assignments.3. Highly developed attention to detail & accuracy of work produced.4. Advanced organizational skills as it relates to working on multiple tasks simultaneously        V. WORK ENVIRONMENT  1. Most tasks are performed in a standard office environment; however, when not in the office environment, tasks may be regularly performed with exposure to adverse environmental conditions, such as dirt, dust, pollen, odors, wetness, humidity, rain, snow, fumes, heights, temperature extremes, noise extremes, machinery, vibrations, electric currents, traffic hazards, explosive hazards, toxic agents, radiation, disease, pathogenic substances, vermin or insect infestation, violence, gang or criminal activity. 2. The normal work routine involves no exposure to blood, body fluids, or tissues (although any work environment presents some small risk of exposure to body fluids).  Individuals who perform these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid.  The normal work routine may involve tasks that involve handling implements or utensils, the use of public or shared bathroom facilities or telephone and personal contacts such as handshaking. VI.  DISCLAIMER This job description is intended to describe the typical duties and responsibilities associated with the identified job.  It does not include all duties and responsibilities of the position.  The Board of Directors or Company officers may assign additional duties that are not listed in this job description.  The order in which duties and responsibilities are listed does not necessarily reflect their relative importance. Contact Information Company: NationsHealth Click here to see all "NationsHealth, Inc." opportunities send this job to a friend